Malabsoprtion Syndrome

Malabsorption Syndrome

The term Malabsorpption syndrome is not used to describe deficient absorption of a single nutrient like vitamin B12, but describes lack of absorption to variable degrees of a number of substances such as fats, proteins, carbs, vitamins and minerals.

Causes:

  1. Small intestinal injury
  2. gluten sensitivity
  3. celiac diseases
  4. TB of small intestine
  5. parasitic infestation
  6. decreased bile salts
  7. laxative drugs
  8. pancreatic enzyme deficiency
  9. short circuiting the bowel

Clinical features:

  1. Chronic ill-health
  2. anemia
  3. fatty fecal mass

Radiological features:

  1. non-specific changes
  2. segmentation and dilatation of the small intestine
  3. stricture
  4. fistula

Clinical Manifestation:

The symptoms may begin at any age, including infancy, but onset after 60is uncommon.

Stunting of growth suggests early development of the problem

Short stature in children may be due to celiac disease

The most common complaints include:

  1. Weakness
  2. weight loss
  3. lassitude
  4. diarrhoeaflatulence
  5. mild abdominal pain
  6. anorexia
  7. nausea
  8. vomiting

Nutritional deficiency manifests as:

  1. glossitis
  2. tetany
  3. bone pains
  4. paresthesia
  5. convulsions

Lab investigations:

  1. Fecal fat excretion test
  2. Blood count
  3. Fasting blood sugar
  4. X-ray of small intestines
  5. small intestinal biopsy

Treatment:

A small peptide based diet may be beneficial to patients with short bowel syndrome

Gluten sensitive celiac diseae may require permanent abstinence from gluten

In Tropical sprue syndrome:

  1. Injection of 5mg Folic acid daily  is given.
  2. Protein malnutrition is corrected on a high protein diet
  3. Broad spectrum anti-biotics are effective when the intestinal bacterial growth is higher.

In fatty stools, medium chain fatty acids can be given.

Food items for a patient on a Gluten Free diet:

  1. Cereals: rice, oatmeal, jowar, bajra, ragi, corn
  2. All pulses
  3. All vegetables
  4. Potatoes
  5. Meat, fish, poultry, eggs
  6. Soups
  7. All fruits
  8. Tea, coffee
  9. Seasoning with ginger, garlic and vinegar
  10. Sweets and sweet meats